Telecare session

‘Mediating care: reading, interpreting and diagnosing code, the ‘new’ skills of ‘caring’?’ Norman Crump – LUMS, Lancaster University

Download Norman Crumps Telecare presentation here>

Elderly panic button

2nd generation telecare system

Notes written by students of Theo Vurdubakis -Department of Organisation, Work and Technology, Lancaster University:

Norman’s presentation focussed on the introduction, development and proliferation of telecare systems in the services of care. Historically, the systems evolved from social alarms to passive and non-invasive home monitoring and, finally, to preventative technological sensors of well-being. In particular, the first generation of telecare included alarms, pendants and wrist-bands, the second incorporated sensors that were built into the fabric of the ‘home’ to monitor activity and the third generation extended to the collection, monitor and storage of data from the sensors, in order to generate screens and diagrams for the carers, indicating how people’s behaviour is changing.

Different aspects of telecare were examined and questioned: telecare as a science of protection, as a service, as ‘informated’ work, as gentrification of work, and finally as an activity of mediation.

With the introduction of security systems the activity of care attempts to protect the vulnerable or the elderly in the same way a conventional security system protects private property. Is telecare a process of commodification? Is protection care?

Within the general political economy of care, telecare as a service was seen as a dignified way of dealing with the vulnerable and the elderly and thus attracted considerable investment that allowed it to proliferate and intensify. Nevertheless, the long-term effects of telecare could not be reconciled with the imperative of short-term return on investment and subsequently its development has stalled.

In relation to the workers/carers, the introduction of telecare systems affected the nature of their work that can now be perceived as informated work. Call centre workers responsible for interpreting and reading the codes conceived of themselves as care workers.

This new form of informated work reconfigured the relationship between the subject at work and the object of work. The body as the site or object of care disappears, that is, it is rendered invisible and it is mediated by and reinterpreted through a new ‘object’: the code. The codification and distancing of the body appears to offer a solution not only to the unfashionable, negative and often messy nature of care work but also as a way to simplify and dissolve the rather complex social relationships, such as race, gender and class, which traditionally constituted care work. Telecare offers the care workers a way out of these complexities by disembodying their work. Thus, it is not only predicated through a positive discourse based on creativity, knowledge and innovation by enhancing the soft skills of the workers but also as a medium that transforms and protects. This shift from responsive to preventative technology questions the very notion of care, which ‘comes into action when protection fails’. In addition, telecare offers a way to make care-work part of the contemporary work culture. It is part of the general shift in the ethos of work where the traditional ideal of ‘giving oneself’ and of self-sacrifice is now occupied by a discourse of self-development and self-enhancement through the engagement with ‘information’. This work ethic runs contrary to the demands from clients of telecare for unskilled work, that is, workers untainted by expertise.

Although telecare can be a science of protection, is it possible to be seen as ‘care’? And how can we think of its desirability? Is it possible for telecare, a technology that mediates between the carer and the cared for, replace care work?

Notes written by Adrian Mackenzie – CESAGen, Lancaster University

Norman Crump described his past employment as a care worker and as a typesetter. This come together in his current research on telecare. He described 2 women working in a call centre he encountered several years ago. They saw themselves as ‘care workers.’ This was surprising, because the setting did not look like a care institution. His paper works through some of the difficulties in thinking about telecare.

The paper began with a description of different telecare systems. The first generation of telecare are alarms. They are pendants, wrist-bands, they are sometimes built into the architecture of the house. The 2nd generation are more personalised. The system watches you through sensors built into the fabric of the building. The system checks whether things are ok, and if not, the call centre telephones, and failing that, other services are called out. The third generation collects data from sensors, monitors and stores it, and generates screens that show how people’s behaviour is changing. The move has been from responsive to preventative technology. The way the technology generates screens is striking. Different thresholds are set for behaviour in homes. Does the reading of these codes be seen as in anyway ‘caring’? This is particularly relevant in 3rd generation systems.

How does this all impact on care of elderly and vulnerable people? Can telecare be seen as a science of protection? The fact that the technology of telecare is the same as security systems leads to the conclusion that telecare is a process of commodification. What is being commodified here? The discourse invokes values of dignity and independence. It has no images of decrepitude or breakdown, but rather a valid way of ‘managing your own demise.’ It might be protective, but is it a form of care? Arguably not. Large amount of resources are being channelled into telecare. However, takeup is rather disappointing. The tool works when it works as a knowledge-sharing infrastructure. It allows different services to be connected. But as a service, it doesn’t, or at least, it is not taking off.

2nd generation telecare monitoring

For knowledge-sharing, it leads to informated work. The call-centre workers act on code, not on bodies. The object of care disappears. Personal care is in large ‘bodywork.’ The low value of care work stems from the bodywork it involves, work that is low status. The complexities of care, and its gender, race, and class differentiations stem from the bodywork. Telecare promises a way out of this. This is part of a broader shift in the nature of work. It has shifted in the way it attends to self or subjectivity. We go to work to work on ourselves, on personal development. From this perspective, care work is unfashionable. Telecare offers a more progressive engagement with care, since it now involves ‘soft skills’ associated with information.

How does care relation to protection? It comes into action when protection fails. People in care sometimes want people to be unskilled. This means perpetual unskilling in order to fulfil the customer-client expectations. Care-work still seems about giving up your self to work for something else. It is here that telecare develops its positive appeal. In many ways it works too well. But all that the telecare system is does is tell the care service what is wrong. It doesn’t help do anything about it. It is just another list of things the service cannot do. There are huge problems here.


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